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WO2006052375A2 - Interface chirurgicale perfectionnee - Google Patents

Interface chirurgicale perfectionnee Download PDF

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Publication number
WO2006052375A2
WO2006052375A2 PCT/US2005/036704 US2005036704W WO2006052375A2 WO 2006052375 A2 WO2006052375 A2 WO 2006052375A2 US 2005036704 W US2005036704 W US 2005036704W WO 2006052375 A2 WO2006052375 A2 WO 2006052375A2
Authority
WO
WIPO (PCT)
Prior art keywords
surgical
unit
operator
interface unit
effector
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/US2005/036704
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English (en)
Other versions
WO2006052375A3 (fr
Inventor
Kenneth Lipow
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Priority to CA002625803A priority Critical patent/CA2625803A1/fr
Publication of WO2006052375A2 publication Critical patent/WO2006052375A2/fr
Anticipated expiration legal-status Critical
Publication of WO2006052375A3 publication Critical patent/WO2006052375A3/fr
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/70—Manipulators specially adapted for use in surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A61B34/37—Leader-follower robots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/70—Manipulators specially adapted for use in surgery
    • A61B34/76—Manipulators having means for providing feel, e.g. force or tactile feedback
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/70—Manipulators specially adapted for use in surgery
    • A61B34/77—Manipulators with motion or force scaling
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots

Definitions

  • the present invention relates to the field of robotic and computer assisted surgery, and more specifically to equipment and methods for robotic and computer assisted microsurgery.
  • the way the primate body handles proprioceptive perception is via sensory feedback scaling (up and down) at the muscular level through the intrafusal fiber system of the Gamma efferent neural circuit.
  • This system responds dynamically to changes in the anticipated muscle performance requirement at any instance by adjusting muscle tone with increased discharging for arousal and attention focusing states, and decrease output for resting and low attention states.
  • the muscle spindle apparatus that does this is located in the muscle body, therefore feedback sensory scaling for muscle positioning, force, length and acceleration is partly programmed at the effector level in "hardware" of the body, i.e., the muscle itself.
  • the evidence indicates a 10 cycle per second refresh rate for the human neurophysiological system in general.
  • Joint position and fine motor function of the fingers occurs through unidirectional (50% of fibers) and bi-directional (50% of fibers) sensing at the joint structure. This coding is for rotation about an axis, but not for force and no clear speed of rotation feedback.
  • Cutaneous receptors in the skin code for motion by modulating higher centers in the thalamus and cerebral cortex. This can be timed to about 75ms delays before motion occurs, including three neuronal synaptic transmission delays. These sensors are primarily distal to the joint of rotation and distal in the moving effector limb. Finally, the sense of contact is totally discrete from the above motion feedback sensory systems and the neural pathways and integration centers in the deep hemispheres and cerebral cortices function independent of motion to a large degree.
  • Force reflectance sensing is also known in order to provide tactile or haptic feedback to a surgeon via an interface. See “Connecting Haptic Interface with a Robot” Bardofer et al., Melecon 200 - 10 th Mediterranean Electrotechnical Conference, May 29-31 2000, Cyprus.
  • Another major design issue regards the choice between locating the surgeon in his normal operating position adjacent to the surgical field or locating the surgeon more remotely from the normal operating position at a terminal with a joystick and viewing screen for example.
  • the prior art elects to locate the surgeon remotely from the traditional operational position about the head and to use monitors to display the operation to the surgeon.
  • a system comprising surgical units and operator interface units configured to provide multiple capabilities within a surgical environment, or within a surgical training environment, is described.
  • the system may provide such capabilities in a modular fashion, such that various functions may be accomplished through the addition or deletion of modules to the system to allow core components to be used to accomplish more than one function.
  • the appliance includes a surgical unit, a controller unit for controlling the surgical unit, and at least a first and a second interface unit, the first and second interface units providing force feedback signals to operators of the interface units, where the first and said second interface units are communicably connected to the controller.
  • the surgical unit is communicably connected to the controller, where the controller includes software for transferring control of the surgical unit from the first interface unit to the second interface unit upon receipt of an indication by an operator of the second interface unit that control of the surgical unit should be transferred from the first interface unit to the second interface unit.
  • the method includes the steps of communicably connecting the first and second interface units to the controller, communicably connecting the surgical unit to the controller, transferring control of the surgical unit to the first interface unit, initiating a surgical procedure utilizing the surgical unit, receiving from an operator of the second interface an instruction to transfer control of the surgical unit from the first interface unit to the second interface unit, transferring control of the surgical unit to the second interface unit when an instruction to transfer control of the surgical unit from the first interface unit to the second interface unit is received, and continuing the surgical procedure.
  • a computer readable media which when executed by a computer implements a process providing control functionality to an augmented surgical appliance, is described.
  • the process includes the steps of transferring control of the surgical unit to the first operator interface unit, receiving from an operator of the second operator interface unit an instruction to transfer control of the surgical unit from the first operator interface unit to the second operator interface unit, transferring control of the surgical unit to said second operator interface unit when an instruction to transfer control of the surgical unit from the first operator interface unit to the second operator interface unit is received, and continuing the surgical procedure.
  • Figure 1 illustrates an augmented surgical interface according to the present invention, wherein two operator interface units are provided to alternately control a single augmented surgical unit.
  • Figure 2 is a notional process flowchart associated with a process for controlling the system of Figure 1.
  • Figure 3 illustrates an augmented surgical interface system according to the present invention, wherein two augmented surgical units are controlled concurrently by a single operator interface unit.
  • Figure 4 illustrates a notional process flowchart associated with a process for controlling the system of Figure 3.
  • Figure 5 illustrates an augmented surgical interface system according to the present invention, wherein a plurality of repeater interfaces are provided to allow operators in training to follow through a surgical procedure in process.
  • Figure 6 illustrates an augmented surgical interface system configured to provide a simulated surgical procedure, wherein the system includes a simulation generator, a first interface unit, a second interface unit, and repeater interface unit.
  • Figure 7 illustrates an augmented surgical interface system according to the present invention, wherein two operator interface units are provided to concurrently control two augmented surgical units via a controller incorporating functionality to deconflict motions of effectors associated with the surgical units.
  • the present invention relates to an augmented surgical appliance, using an operator interface 102 for a surgeon 104 combined with an augmented surgical unit portion 106 for performing surgical procedures.
  • the interface and surgical unit portions are interconnected via a controller 108, which receives input from the interface 102, and converts the input to output performed by the surgical unit 106.
  • Feedback is provided to the interface 102 from the controller 108 in response to parameters measured at the surgical unit 106.
  • the controller may be provided with a plurality of communications ports 110 for receiving input from one or more interfaces 102, 112.
  • the controller 108 may also be provided with one or more control ports 114 for providing control signals to the surgical unit 106.
  • a single surgical unit 106 may be controlled by a plurality of interface unites 102, 112, where the controller includes functionality for integrating the inputs from the multiple interface units 102, 112 in a coordinated fashion so as to prevent inadvertent signals being transmitted to the surgical unite 106.
  • a single surgical unit 106 may be connected to a control port 114 associated with the controller 108, while an instructor interface 102 and a student interface 112 are connected to communications ports 110 associated with the controller 108.
  • Such a system embodiment allows the instructor interface 102 to provide an instructor 104 to closely observe a surgical procedure, and assume control of the surgical unit 106 either for safety or instructional purposes.
  • Such a process is shown in Figure 2, wherein an instructor interface and a student interface have been provided 202, 204 in conjunction with a single surgical unit positioned 206 in the surgical field.
  • control of the surgical unit may be transferred 214 to the student interface.
  • the instructor may monitor 216 the procedure. If the instructor determines 220 that an over-ride of the student control of the surgical unit is indicated, the instructor may request 220 control of the surgical unit.
  • the transfer may either be a transfer of motion control, may cause a suspension of further motion by locking the motion of the surgical unit, or may cause the surgical unit to translate any tools in use to a safe position.
  • the controller may command 224 retraction of the instrument to a safe position. If the instructor does not desire to have the instrument retracted, it may then be determined 228 whether the instructor desires the instrument to be held in place. If the instructor desires the instrument to be held in place, the controller may command 230 that the instrument be held at a location until released by the instructor.
  • an instrument may be determined 232 whether the instrument should be fixed as to condition (i.e., open or closed for a forceps), and if it is determined that it is desired to fix the instrument in a condition, the controller may command 234 that the instrument be fixed as to condition until released to the operator.
  • control of the surgical unit may be transferred 236 to the instructor.
  • This determination of transfer parameters may be extended to multiple effectors/instruments in use, i.e., parameters may be obtained for both an effector associated with a right hand control and for an effector associated with a left hand control. Transfer parameters may also be preconfigured, such as should an instructor require a rapid transfer of control, the instruments/effectors could be preconfigured to transfer as free, to a retracted position, to a hold position, and/or a fixed condition.
  • the procedure may continue with the instructor in control until the instructor determines 240 that control should be transferred back to the student, at which point control may be transferred 214 to the student.
  • Such transfer may additionally implement retraction of instruments in use, position hold for instruments in use, and a condition fix for instruments in use.
  • the system may be configured in the operating room to include two surgical units 302, 304, associated with a single interface unit 306 via a controller 308.
  • the interface unit 306 may typically have two hand controllers 3310, 312, corresponding to the left and right hands (not shown) of an operator 314.
  • the surgical units 302, 304 may typically have more than one effector 316 per surgical unit 302, 304 (two effectors per unit are shown), such that an operator 314 has four (4) possible effectors to control from two hand controllers 310, 312.
  • the use of multiple effectors allows a larger tool set to be available to the operator 314.
  • the surgical environment may be provided with an inter unit 406, as well as be provided 402, 404 with first and second surgical units.
  • the interface and surgical units may be communicably connected 410 to a controller. Control of the surgical units may be transferred 412 to the interface, at which point the operator may select 414 effectors and associate them with hand controllers.
  • an effector on the first surgical unit may be associated with the right hand controller, while an effector associated with the second surgical unit may be associated with the left hand controller.
  • Such association may not only provide control authority over the given effector by a selected hand controller, it may also cause the controller to apply feedback parameters associated with the selected effector to the hand controller.
  • the surgical procedure may be initiated 416. If the operator determines 422 during the procedure that different effector assignments are desired (i.e., use of a new effector or re-assignment of an effector in use to a different hand controller is desired) the operator may identify 426 the new effector/hand control assignment to the controller.
  • the position and condition of the effector will typically be of significance, such as where a tool for retracting flesh is being deselected. If the retractor were erroneously retracted, it could cause complications of the surgical procedure. Accordingly, it may be desirable to fix the effector in a position to allow a tool in use on the effector to remain in use after the effector is deselected. Alternately, it may be desirable to have the tool automatically retracted to a position outside of the surgical field. The surgeon operating the interface may thus indicate which response is desired.
  • the operator may further indicate whether it is desired that the tool remain in the additional conditions, such as clamped or undamped for a forcep tool.
  • the transfer condition of an instrument may be defined by the operator. If it is determined 426 that the operator desires an effector/instrument to be retracted prior to the transfer, effector/instrument may be retracted 428. If it is determined 430 that the operator desires that a de-selected effector/instrument be held in position, the controller may issue commands to hold 423 the effector/instrument in position.
  • the controller may issue commands to fix the instrument in a given condition. Holding an instrument in position may be included when an effector/instrument is fixed as to position. If neither retract, hold, and/or fix as indicated, the operator may be queried to determine which condition the de ⁇ selected instrument should be left in. Once the condition of the deselected effector/instrument has been determined and accomplished, control of a selected effector/instrument may be assigned 440 to an identified control handle, and the surgical procedure may continue.
  • the augmented surgical interface system may further be implemented to allow one or more operators in training 502, 504, 506 to follow through a surgical procedure being performed by a first surgeon 508.
  • the surgeon 508 may be provided with an interface unit 510 connected to a controller 512.
  • a surgical unit 514 having one or more effectors 516 may additionally be connected to the controller.
  • Repeater interfaces 518, 520, 522 may be provided to allow operators in training 502, 504, 506 to follow through as the first surgeon 508 performs a procedure.
  • the repeater interfaces would not have control authority over the surgical unit 514, however would receive display and feedback parameters from the controller 512, such that control handles 524 on the repeater interfaces 518, 520, 522 would mirror the positioning of the control handles 526 on the operator interface 510.
  • the feedback systems utilized in the interface units as described previously would cause the control handles 524 to mirror the motions of the first surgeon's control handles 526.
  • the provision of display units 528 on the repeater interfaces 518, 520, 522 would allow the operators in training 502, 504, 506 to also see the visual presentations being provided to the first surgeon 508.
  • the repeater interfaces 518, 520, 522 may be the same as the interface unit
  • controller 512 is used to prevent the repeater interfaces 518, 520, 522 from having any control authority over the surgical unit 514.
  • the use of common interface units may reduce the cost of implementing such a system on a hospital, such that where a hospital procures surgical units for more than one operating theater, the associated interface units may be aggregated in a single operating theater for a procedure which is to be followed through by operators in training, without the hospital having to procure additional equipment.
  • a simulation generator 602 may be connected to a controller 604.
  • the simulation generator 602 may be provided with an environment model 606 for defining expected responses as a tool moves within a simulated surgical field.
  • Such an environment model 606 may include parameters defining tissue position and consistency, as well as tissue response parameters to various surgical instruments which may be encountered during a simulated surgical procedure.
  • the simulation generator 602 may further be provided with a display generator 608 for generating a simulated display of the surgical field, including tissue and tool positioning, as well as indicators and feedback that would be provided to a surgeon during a procedure.
  • the simulation generator may further be provided with a kinematics model 610 that models the kinematic response of surgical instruments within the surgical field, such as contact information, acceleration forces and other motion forces which would be encountered during an actual procedure.
  • the output of the simulation generator may be provided to the controller, such that the controller is provided with signals which would be consistent with the signals transmitted to the controller during an actual procedure.
  • a first interface unit 612 may be designated as the controlling interface unit, such that commands provided by an operator 614 of the first interface unit would be used to provide command parameters for a simulated surgical procedure.
  • a second interface unit 616 could be provided for a supervising surgeon or operator 618, such that the training system of Figure 1 could be implemented in a simulated environment, such as may be desired to familiarize an operator in training 620 with the hand off procedures.
  • a third interface unit 622 may also be provided to allow a second operator in training 624 to follow though the simulated procedure, or to step in upon the directions of the supervising surgeon or operator 618.
  • the third interface may alternately be limited such that control authority could not be transferred to the third interface unit 622, effectively rendering the third interface unit to be a repeater interface unit.
  • the position of tools within the surgical field may be modeled as a function of the position of the surgical units to a fixed reference, such as the surgical table. The use of such referencing was discussed previously.
  • the resultant position of the surgical instruments could be determined by the controller 712 as a function of the position of the effectors to which the instruments are attached, as well as predetermined knowledge of the instruments themselves.
  • the position of the tools is important in preventing interference between the tools, predictive analysis of the motion of the instruments themselves may provide a more effective function for the operators.
  • the projected position of the tools may be based on the present motion and speed of the instruments, such that an increasing value can be determined indicating the likelihood of interference between the instruments. Such a value may be increased the sooner an interference may occur, i.e., a likely interference that will not occur for a longer period of time will be assigned a lower value than a likely interference which will occur sooner.
  • An indication of the likelihood of contact may be presented to one or both of the operators during a procedure with multiple interface units.
  • the indicator may be a visual or audible warning to the operators.
  • the controller may impose a scale function to the motion of the instruments as a function of the likelihood of the interference. For example, a velocity component of a commanded motion of an instrument may be reduced by an increasing factor the higher the likelihood of an interference. Thus, minimal scaling of the motion command would occur where the interference was of a lower likelihood, i.e., not expected to occur for a given amount of time. As the likelihood of the interference is expected to occur sooner, the scaling of the motion command may be increased to further slow the motion of the instrument, thus reducing the likelihood of an interference, as well as signaling the operator of the likelihood of the interference.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Robotics (AREA)
  • Medical Informatics (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Manipulator (AREA)
  • Instructional Devices (AREA)

Abstract

Cette invention a pour objet un système comportant des unités chirurgicales et des unités d'interface opérateur conçues pour ajouter des capacités multiples au sein d'un environnement chirurgical ou au sein d'un environnement d'apprentissage chirurgical. Le système peut renforcer ces capacités selon un mode modulaire, de telle sorte que diverses fonctions puissent être accomplies par l'ajout ou la suppression de modules au système pour que les éléments principaux puissent être utilisés pour accomplir plus d'une fonction.
PCT/US2005/036704 2004-10-12 2005-10-12 Interface chirurgicale perfectionnee Ceased WO2006052375A2 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CA002625803A CA2625803A1 (fr) 2004-10-12 2005-10-12 Interface chirurgicale perfectionnee

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US61786404P 2004-10-12 2004-10-12
US60/617,864 2004-10-12

Publications (2)

Publication Number Publication Date
WO2006052375A2 true WO2006052375A2 (fr) 2006-05-18
WO2006052375A3 WO2006052375A3 (fr) 2009-04-23

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PCT/US2005/036704 Ceased WO2006052375A2 (fr) 2004-10-12 2005-10-12 Interface chirurgicale perfectionnee

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CA (1) CA2625803A1 (fr)
WO (1) WO2006052375A2 (fr)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2008012386A1 (fr) * 2006-07-28 2008-01-31 Universidad De Málaga Système robotique d'aide à la chirurgie minimement invasive capable de positionner un instrument chirurgical en réponse aux ordres d'un chirurgien sans fixation à la table d'opération ni calibrage préalable du point d'insertion
EP2142133A4 (fr) * 2007-04-16 2011-02-23 Neuroarm Surgical Ltd Méthodes, dispositifs et systèmes de mouvements automatisés concernant des robots médicaux
WO2017070269A1 (fr) 2015-10-22 2017-04-27 Covidien Lp Procédé de commande de système chirurgical robotisé à entrées multiples
CN115054368A (zh) * 2021-05-25 2022-09-16 陈新治 一种准直导向系统
US11779416B2 (en) 2018-01-04 2023-10-10 Covidien Lp Robotic surgical systems and instrument drive assemblies

Family Cites Families (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5515489A (en) * 1991-12-31 1996-05-07 Apple Computer, Inc. Collision detector utilizing collision contours
US5855583A (en) * 1996-02-20 1999-01-05 Computer Motion, Inc. Method and apparatus for performing minimally invasive cardiac procedures
US5748097A (en) * 1997-02-28 1998-05-05 Case Corporation Method and apparatus for storing the boom of a work vehicle
EP1109497B1 (fr) * 1998-08-04 2009-05-06 Intuitive Surgical, Inc. Eléments articules servant à positionner un manipulateur, dans une chirurgie robotise
US6459926B1 (en) * 1998-11-20 2002-10-01 Intuitive Surgical, Inc. Repositioning and reorientation of master/slave relationship in minimally invasive telesurgery

Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2008012386A1 (fr) * 2006-07-28 2008-01-31 Universidad De Málaga Système robotique d'aide à la chirurgie minimement invasive capable de positionner un instrument chirurgical en réponse aux ordres d'un chirurgien sans fixation à la table d'opération ni calibrage préalable du point d'insertion
EP2142133A4 (fr) * 2007-04-16 2011-02-23 Neuroarm Surgical Ltd Méthodes, dispositifs et systèmes de mouvements automatisés concernant des robots médicaux
US8738181B2 (en) 2007-04-16 2014-05-27 Alexander Greer Methods, devices, and systems for automated movements involving medical robots
WO2017070269A1 (fr) 2015-10-22 2017-04-27 Covidien Lp Procédé de commande de système chirurgical robotisé à entrées multiples
EP3364905A4 (fr) * 2015-10-22 2019-07-10 Covidien LP Procédé de commande de système chirurgical robotisé à entrées multiples
US10973597B2 (en) 2015-10-22 2021-04-13 Covidien Lp Multi-input robot surgical system control scheme
US11666403B2 (en) 2015-10-22 2023-06-06 Covidien Lp Multi-input robot surgical system control scheme
US11779416B2 (en) 2018-01-04 2023-10-10 Covidien Lp Robotic surgical systems and instrument drive assemblies
CN115054368A (zh) * 2021-05-25 2022-09-16 陈新治 一种准直导向系统
CN115054368B (zh) * 2021-05-25 2024-04-09 陈新治 一种准直导向系统

Also Published As

Publication number Publication date
CA2625803A1 (fr) 2007-05-18
WO2006052375A3 (fr) 2009-04-23

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